BACKGROUND: To compare the diagnostic value between Phalen's test and reverse Phalen's test using a morphological change of the median nerve and the carpal tunnel in diabetics and normal controls seen by high-resolution ultrasonography and to research on an ultrasonography as an available tool for the screening and follow up aid-test of the carpal tunnel syndrome(CTS). METHODS: A cross-sectional area and a flattening ratio of the median nerve, and a cross-sectional area of the carpal tunnel were measured in neutral, maximally flexed(Phalen's test), and maximally extended (reverse Phalen's test) positions in 59 wrists of 30 normal controls and 60 wrists of 30 diabetics. RESULTS: 1) In controls and diabetics, the mean cross-sectional area of median nerve at the hamatum were 8.8/10.2 mm2, 8.0/9.5 mm2, 8.3/9.4 mm2, the mean flattening ratio were 3.0/3.0 mm2, 2.4/2.0 mm2, 3.2/3.0 mm2, the mean cross-sectional area of carpal tunnel were 176.5/197.7 mm2, 157.9/187.0 mm2, 170.6/192.5 mm2 in neutral, maximal flexion and maximal extension. 2) In controls, the cross-sectional area of median nerve and carpal tunnel were significantly decreased in maximal flexion(p<0.01), and in maximal extension(p<0.01). 3) In controls, the mean flattening ratio of median nerve was revealed significant change in maximal flexion(p<0.01), and in maximal extension(p<0.01). 4) In diabetics, the flattening ratio was significantly decreased in maximal flexion(p<0.01) with com- paring to neutral position. 5) In diabetics, the cross-sectional area of median nerve and carpal tunnel were significantly increased in all positions(p<0.05), and the mean flattening ratio of median nerve was similar to controls. CONCLUSION: In diabetics, increased cross-sectional area of median nerve can be explained by swelling of median nerve, also increased cross-sectional area of carpal tunnel is can be said to have taken place by the decreasing of the useful space in between the median nerve and carpal tunnel, this show that the diabetics have the high risk of the CTS. Phalen's test reveals higher degree of irritation to median nerve, The high-resolution ultrasonography is suggested as an available tool for the screening and follow up aid-test for the CTS
Carpal Tunnel Syndrome ; Follow-Up Studies ; Mass Screening ; Median Nerve* ; Ultrasonography ; Wrist*

BACKGROUND: Helicobacter pylori(H. pylori) has been implicated in the pathogenesis of chronic active gastritis and peptic ulcer disease. All patients with ulcers who are infected with H. pylori receive antimicrobial therapy. Therefore diagnosis of H. pylori infection is imperative for the treatment gastritis or ulcer patients. We evaluated the four diagnostic methods and three culture media for the isolation of H. pylori. MATERIALS AND METHODS: Rapid urease test(CLO test), modified Gram stain, culture, and nested polymerase chain reaction (PCR) were performed with 108 gastroscopic biopsy specimens from patients with peptic ulcer or chronic gastritis. Among them 40 specimens were inoculated onto each of 5% sheep blood agar, e99 Yolk emulsion (EYE) agar, and 7% horse blood agar containing antibiotics. RESULTS: The positive rates were the highest by the PCR(72%), 67% by modified Gram stain, 64% by CLO test, and 57% by culture. Among the three media the horse blood agar (selective medial) gave the highest isolation rate (48%), followed by sheep blood agar (45%), and EYE agar (38%). CONCLUSION: Though PCR was the most sensitive method for the detection H. pylori modified Gram stain was sensitive enough, simple, rapid, and economical as the routine diagnostic method of H. pylori. For the culture of H. pylori combination of sheep blood agar as nonselective media and horse blood agar as selective media would show the highest isolation rate.
Agar ; Anti-Bacterial Agents ; Biopsy* ; Culture Media* ; Diagnosis ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Horses ; Humans ; Peptic Ulcer ; Polymerase Chain Reaction ; Sheep ; Ulcer ; Urease

PURPOSE: The purpose of this study was to identify factors that affect reality shock in new nurses. METHODS: Participants were 216 newly graduated nurses with less than 1 year experience in 5 university and 10 general hospitals in Busan, Ulsan and Gyeongnam, A self-report questionnaire was completed by the nurses between November 18 and December 25, 2013. Data were analyzed using t-test, ANOVA and hierarchial multiple regression analysis with the SPSS/WIN 21.0 Program. RESULTS: Average scores for work environment and environmental reality shock were 2.63+/-0.33 and 2.66+/-0.43 points respectively. Regression analysis showed that with the nurses' demographic and work characteristics controlled, work environment explained 4.2% of the reality shock. Factors significantly affecting reality shock included nurses' changing residence because of job (beta=.21, p=.001), whether they were able to work on the unit of their choice (beta=-.13, p=.031) and whether they had a choice in days off (beta=-.14, p=.038). CONCLUSION: When these factors are considered, reduction in nurses' reality shock requires improvement in work environment, placing new nurses in a department of their choice and allowing them a choice in off-duty days. These measures would also help achieve organizational goals and develop the new nurses as professional nurses.
Busan ; Hospitals, General ; Organizational Objectives ; Surveys and Questionnaires ; Shock* ; Ulsan

BACKGROUND: Microlymphocytotoxicity test is most widely used for HLA Class l typing but almost all laboratories depend on imported HLA Class 1 typing trays. Matching criteria for the selection of HLA- matched platelets to treat platelet refractoriness is not as strict as for bone marrow transplantation. Therefore, with the acquisition of various antisera against high frequency HLA antigens, self-made HLA typing trays can be used for HLA typing of HLA-matched platelet donors. METHODS: 140 samples obtained during placental delivery were tested for the presence of HLA antibodies against a well-characterized panel of 90 cells. Specificity of HLA antisera were determined by evaluating the correlation coefficient r of the 2 x 2 table, x2 test. Antisera strength was evaluated by the strength index. RESULTS: HLA antibodies were detected in 25 samples by primary screening and 23 samples also showed a positive reaction in secondary screening(16%). Among 23 samples, 1 1 antisera were of reagent grade quality and 7 were monospecific antisera. DISCUSSION: Imported HLA typing trays can be replaced by harvesting HLA antisera against HLA antigens which are relatively common in Koreans through continuous HLA antibody screening using gushed out blood during placental delivery. (Korean J Blood Transfusion 10(1): 53-60, 1999)
Antibodies ; Blood Platelets ; Blood Transfusion ; Bone Marrow Transplantation ; Histocompatibility Testing ; HLA Antigens ; Humans ; Immune Sera ; Mass Screening ; Sensitivity and Specificity ; Tissue Donors

This study examined the effects of a brown rice vegetarian diet and outdoor walking exercise program on body composition and blood lipid parameters in collegians. The mean age of respondents was 21.8 yrs (males) and 21.7 yrs (females). During the ten-day program, the respondents lived in a dormitory and had three meals. The respondents exercised one hour in the morning (6:20~7:20 am) and attended one and a half hour evening lecture (7:00~8:30 pm) everyday. The brown rice vegetarian diet consisted of brown rice, whole grain bread, beans, fresh vegetables, and fresh fruits contained 2043.2+/-112.7 kcal (97.3% of RNI), 66.7 g protein (133.3% of RNI), 33.6 g dietary fiber (168.2% of RNI), vitamin A (194.2% of RNI), vitamin B1 (245.5% of RNI), vitamin B2 (225.1% of RNI), niacin (233.7% of RNI), vitamin B6 (277.1% of RNI), folic acid (128.4% of RNI), vitamin C (334.6% of RNI), iron (131.9% of RNI), zinc (112.4% of RNI) and calcium (60.3% of RNI). The results showed that there were significant increases in body weight (P<0.05) and BMI (P<0.05) in males and body weight (P<0.05) and lean body mass (P<0.01) in females. In addition, there were significant decreases in total cholesterol (P<0.001), LDL cholesterol (P<0.001), TG (P<0.05), and HDL-cholesterol (P<0.001) in males and total cholesterol (P<0.01) and LDL-cholesterol (P<0.01) in female. The ten day brown rice vegetarian diet rich in fiber and outdoor walking exercise program significantly increased body weight and decreased total cholesterol and LDL-cholesterol in collegians.
Ascorbic Acid ; Body Composition ; Body Weight ; Bread ; Calcium ; Edible Grain ; Cholesterol ; Cholesterol, LDL ; Surveys and Questionnaires ; Diet, Vegan ; Dietary Fiber ; Fabaceae ; Female ; Folic Acid ; Fruit ; GTP-Binding Proteins ; Humans ; Iron ; Male ; Meals ; Niacin ; Riboflavin ; Thiamine ; Vegetables ; Vitamin A ; Vitamin B 6 ; Walking ; Zinc

PURPOSE: The purpose of this study was to define and clarify the concept of reality shock in new graduated nurses. METHODS: The hybrid model was used to develop the concept of reality shock. The model included a field study. The participants were 9 newly graduated nurses with a nursing career spanning less than a year. RESULTS: The reality shock in newly graduated nurses was identified to have three dimensions and seven attributes. Specifically: 1) the dimension of performance included two attributes (conflict between theory and practice, and being overwhelmed by the workload), 2) the dimension of relationship included three attributes (loss of support, embarrassment from interference, and relational withdrawal), 3) the dimension of expectations included two attributes(value confusions and incongruity in personal life). CONCLUSION: Newly graduated nurses' reality shock was defined as a state of incongruence in their entire life that the new nurses experienced owing to value confusions that occurred due to the conflicts between theory and practice in an unfamiliar work environment, getting overwhelmed by the workload, and withdrawing establishing relationships with others due to the loss of support and excessive interference. These findings could help develop intervention strategies to decrease reality shock in newly graduated nurses.
Humans ; Nursing ; Shock*

PURPOSE: The staging of bladder carcinoma is a major determinant of operative management. CT of bladder carcinoma has been widely used to diagnose external extension (pT3b and over), but tumors confined to the bladder wall (from pT1 to pT3a) are poorly delineated. The authors describe CT findings of the superficial bladder carcinoma (below T1, stage A) in thin section CT with air insufflation technique (air insufflation-CT) to facilitate early detection and to aid correct staging of the superficial bladder carcinoma. MATERIALS AND METHODS: The materials consisted of proved 24 cases (1'9 patients, single tumor: 16 patients, multiple tumors :3 patients) of stage A bladder carcinomas. Air insufflation-CT was performed by the infusion of approximately 200 mL of air into the bladder via a Foley catheter. After the routine pelvic CT, bladder tumors were re-scanned with 1.5 to 5 mm thickness and intervals. RESULTS: The superficial bladder carcinomas were detected as nodular(5 cases, 20.8%), papillary(15 cases, 62.5%), pyramidal(2 cases, 8.3%), and domed(2 cases, 8.3%) forms on air insufflation CT. These tumors were classified into three types according to the size of the tumoral neck:type I(pedundulated polypold tumor:4 cases, 16.6%), type II(polypid tumor with short neck :13 cases, 54.2%), and type Ill(sessile tumor :7 cases, 29. 2%). The mean size(tumoral width x height x base o, neck/stalk) of the tumors was 22 x 20 x 16mm. The average tumoral sizes according to each type of the superficial tumors were type 1:22 x 25 x 6mm, type 11:23 x 22 x 18mm, and type III :18 x 15 x 18mm. The mean width of the type I--II tumoral necks was 15mm. The mean length of the type I tumoral neck(pedicle) was 2.5mm. Papillary fronds of the tumors were seen in 10 cases(41.7%) of 24 superficial tumors. Outer margin of the involved bladder wall was smooth in all cases. CONCLUSION: Thin-sectin CT with air insufflation technique for bladder carcinoma was useful in tumoral demonstration, and characteristics of the superficial bladder carcinomas were small polypold tumors had a short neck mostly and smooth outer wall of the involved bladder wall.
Catheters ; Humans ; Insufflation* ; Neck ; Urinary Bladder Neoplasms ; Urinary Bladder*

Total abdominal hysterectomy was considered an inadequate treatment method for invasive cervical cancer. Usually the procedure was inadvertently performed on patients who were thought preoperatively to have benign conditions. Survival for patients with gross disease remaining after inappropriate hysterectomy is poor. So, early cancer detection and proper management with precise pretreatment staging is necessary to avoid inadequate hysterectomy, especially in cases of gross residual disease. Cervical cancer typically recurs at the vaginal vault or in the pelvis; however it can recur distantly in the abdomen or lung. Although recurrences have been reported at laparoscopic trocar sites, it is unusual to have recurrence in the abdominal wall after laparotomy. A case of isolated metastasis to the abdominal wall after treatment of unexpected invasive cervical cancer found at total hysterectomy is presented with a brief review of the literature.
Abdomen ; Abdominal Wall* ; Humans ; Hysterectomy* ; Laparotomy ; Lung ; Neoplasm Metastasis* ; Pelvis ; Recurrence ; Surgical Instruments ; Uterine Cervical Neoplasms*

OBJECTIVES: This study was conducted to analyze the current state and tendency of oral health inequality in 12-year-old Korean children by calculating the Gini coefficient from decayed, missing, or filled teeth (DMFT) data. METHODS: Ten-year trends were empirically estimated by calculating the Gini coefficient from the Lorenz curve plotted based on the DMFT data of 12-year-old children, obtained from the Korean National Oral Health Survey from 2000 to 2010. RESULTS: While the oral health improved in general, oral health inequalities increased with the decrease in the number of DMFT each year, and the DMFT-based Gini coefficient increased from 0.53 in 2000 to 0.61 in 2010. The increase in the number of decayed and missing teeth was strongly affected by the increase in oral health inequality. CONCLUSIONS: To resolve Korea's continually increasing oral health inequality, it is necessary to establish support measures for vulnerable populations and to develop and manage a surveillance system for continuous monitoring of oral health inequality in the future.
Child ; Humans ; Oral Health ; Socioeconomic Factors ; Tooth ; Vulnerable Populations

Neuronal migrational disorders of the brain represent abnormalities in the formation of the neocortex caused by faulty migration of the subependymal neuroblasts. The neuroblasts normally migrate between the sixth and 15th gestational week and in doing so form the six-layered neocortex. When the migration does not occur in a normal fashion the resultant brain anomalies include lissencephaly, pachygyria, schizencephaly, hemimegalencephaly, heterotopia, and polymicrogyria. Neuronal heterotopia is a collection of nerve cells in abnormal locations as a result of arrest of their radial migration, improper formation, or destruction of the radial glial fiber. We reported a case of neuronal heterotopia with brief review of related literatures.
Agenesis of Corpus Callosum ; Brain ; Lissencephaly ; Malformations of Cortical Development ; Neocortex ; Neuronal Migration Disorders ; Neurons*